Suzi Ann Wallace, BS PHARMACY

Primary specialty

PharmacistTaxonomy code 183500000X

License

PH23379 Issued in MA

Practice address

1 Deaconess Rd
West Campus Ind Pharmacy CCB-011
Boston, MA 02215-5321

Phone

(617) 754-3844

Fax

(617) 754-3845

NPI assigned

Dec 28, 2009

Last updated

Dec 28, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1261958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261958400000",
    "number": "1548590441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DEACONESS RD",
            "address_2": "WEST CAMPUS IND PHARMACY CCB-011",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155321",
            "telephone_number": "617-754-3844",
            "fax_number": "617-754-3845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DEACONESS RD",
            "address_2": "WEST CAMPUS IND PHARMACY CCB-011",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155321",
            "telephone_number": "617-754-3844",
            "fax_number": "617-754-3845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "SUZI",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "BS PHARMACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-28",
        "last_updated": "2009-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH23379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Wallace
• Nicole Wallace
• Ryan Lee Wallace, MD
• Sharon Wallace
• Sierra R Wallace, MD
• Timothy R Wallace, PHD
• William Wallace
• Zachary S Wallace, M.D.
• Karen Wallach, D.M.D.
• Brianna Frances Waller, MD

• Pharmacist in Boston, MA
• Providers in Boston, MA by specialty
• Pharmacist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.